This section describes the scope and purpose of the Czech HSPA and the process that led to its definition and mutual recognition among the involved stakeholders. It also shows the links the HSPA has with regard to the national strategic priorities in health and health policy. More information on operationalising the HSPA and the Czech strategic development Health 2030 is provided in Annex B.
Health System Performance Assessment Framework for the Czech Republic
2. The purpose and scope of the Czech HSPA
2.1. The process
The purpose and scope of the Czech HSPA was developed through consultations with the members of the principal working group and the high-level advisory board (HLAB). A dedicated working group workshop was held on the topic on 1 October 2021. Based on this workshop and subsequent consultations, the HLAB members noted the first draft of the HSPA Purpose and Scope during its meeting in January 2022 and the detailed version of it during the meeting in June 2022. This detailed version profited from further refinements and clarifications, mainly in accordance with the gradual development of the HSPA framework, the technical focus groups, and consultations with working group members.
From the very beginning of the project, project participants identified a significant value in having a dedicated the Czech HSPA and stressed the need to create a sustainable HSPA governance from the very start of its implementation. In January 2023, the HLAB approved the proposed HSPA governance structure which clearly links the HSPA main outputs to the defined HSPA purpose and scope (see Section 5.3).
2.2. The Czech HSPA purpose
The approved purpose of the Czech HSPA is illustrated in Figure 2.1. The Czech HSPA aims to support healthcare stakeholders in their effort to attain the ultimate goal of the Czech healthcare system. This goal is defined by the Strategic Framework for Health Care Development in the Czech Republic to 2030 (the so-called Health 2030) as follows: “The health status of all population groups is continuously improving.” This is further detailed out in the strategic document’s introductory section (MZČR, 2020[2]).
The HSPA implementation is aimed at increasing accountability of principal stakeholders, improving public involvement, ensuring smooth flow of information across the health sector, and at allowing reform planning and monitoring. Overall, the HSPA framework will enable the assessment of strengths and weaknesses of the Czech healthcare system.
Figure 2.1. The purpose of the Czech HSPA
Source: The Czech HSPA project.
2.3. The scope of the Czech HSPA
The HSPA primarily serves as a tool providing for an overview of (un)desirable development in health sector domains of interest. The HSPA is not intended to substitute a specific analysis on a given issue, however. It may indicate causes of a particular development, but not necessarily provide analysis of the cause itself.
According to the Czech HSPA purpose, the HSPA shall also improve the information disclosure on state of the Czech healthcare sector, on the population health status, and on healthcare outcomes, enabling country comparisons, time trend analyses, and population subgroups overview. In line with this, the scope of the framework shall provide an overview for the assessment in the following categories:
health status development,
changes in health sector performance,
healthcare quality development,
outcomes and impacts of health policy measures and health system investments both in public health domain and in healthcare provision,
the accessibility of healthcare for population subgroups in terms of geography, time, and financing.
2.4. Linking the Czech HSPA to national strategic priorities
The Czech HSPA purpose and scope explicitly addresses the need for the framework to monitor policy priority areas. Thus, the HSPA domains and indicators were selected (see Sections 3 and 4) taking the national health objectives into account and some of the indicators are in direct match with the indicators included in the strategic priority monitoring.
The Strategic Framework for Developing Healthcare in the Czech Republic to 2030 (called “Health 2030”) was first approved in 2019 and revised in 2020 due to the COVID‑19. The Ministry of Health and its subsidiary bodies are responsible for its delivery until the end of 2030. The Health 2030 strategy builds on and includes previous national health strategies, including the Health 2020 strategy, the National eHealth Strategy, Primary Care Reform and Psychiatric Care Reform. For goals of the Health 2030 strategy, please see Annex B. Other recent health policy strategic documents include for instance the National Oncology Plan, approved by the government in June 2022.
During the indicator review and selection process, special attention was thus paid to indicators related to the primary care, mental health care, dental care, cancer care, and palliative care. Access, quality, integrated care delivery, prevention, and workforce feature among the Czech health policy priorities and at the same time are an integral part the HSPA framework itself (see Section 3.2).
To monitor policy priority achievements and reform progress for mentioned types of care, the Czech HSPA framework offers multiple assessment perspectives across its domains. For instance, strengthening of primary care can be monitored across several HSPA domains’ perspective: the accessibility to care provision, the level of care continuity, the quality of care co‑ordination, appropriateness of care, workforce capacity, and equity in service provision. Other policy priorities, such as quality of care, are directly aligned with a particular domain of the framework.
For additional information:
Annex B: Defining the HSPA scope and purpose in line with national health priorities.
Operationalising the Czech HSPA scope and purpose
The Health 2030 strategy goals